Northwest Medical Specialties Pharmacy

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

License

PF00056036 Issued in WA

Legal business name

NORTHWEST MEDICAL SPECIALTIES PHARMACY

Practice address

1624 S I St
Suite 305
Tacoma, WA 98405-5016

Phone

(253) 428-8700

NPI assigned

Nov 30, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Barbara Derry

Title

Administrator

Phone

(253) 428-8700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Northwest Medical Specialties PLLC

  • Multi-Specialty Clinic/Center
  • Tacoma, WA
  • NPI 1548261308

  O20100930041047

  Same enrollment

Locations

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robin L Vargo, P.A.

  • Physician Assistant
  • Joint Base Lewis McChord, WA
  • NPI 1629378641
  NPD
• Ashley Elizabeth Aller, M.D.

  • Hematology & Oncology Physician
  • Seattle, WA
  • NPI 1730674565
  NPD (past)
• William Ira Bensinger, MD

  • Medical Oncology Physician
  • Lakewood, WA
  • NPI 1922198886
  NPD (past)
• Kenneth S Bergman, MD

  • Radiation Oncology Physician
  • Gig Harbor, WA
  • NPI 1669443032
  NPD (past)
• Sibel Blau, M.D.

  • Hematology & Oncology Physician
  • Puyallup, WA
  • NPI 1962490797
  NPD (past)
• Thomas E. Boyd, MD00022875

  • Hematology & Oncology Physician
  • Spokane, WA
  • NPI 1518049642
  NPD (past)
• Mandie Michelle Brown, ARNP

  • Family Nurse Practitioner
  • Lacey, WA
  • NPI 1942808506
  NPD (past)
• Jorge M Chaves, M.D.

  • Hematology & Oncology Physician
  • Tacoma, WA
  • NPI 1265610752
  NPD (past)
• Aliakbar Rashid Dadla, M.D.

  • Hematology & Oncology Physician
  • Vancouver, WA
  • NPI 1134474976
  NPD (past)
• Susan L Fraser, MD

  • Infectious Disease Physician
  • Tacoma, WA
  • NPI 1932187663
  NPD (past)
• Flora Lea Galloway, FNP-BC

  • Family Nurse Practitioner
  • Tacoma, WA
  • NPI 1205330503
  NPD (past)
• Marles Jean Geist, RN, ARNP

  • Adult Health Nurse Practitioner
  • Chehalis, WA
  • NPI 1073759486
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053489062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 S I ST",
            "address_2": "SUITE 305",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055016",
            "telephone_number": "253-428-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 S I ST",
            "address_2": "SUITE 305",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055016",
            "telephone_number": "253-428-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MEDICAL SPECIALTIES PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DERRY",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "253-428-8700"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "WA",
            "license": "PF00056036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwest Center for Integrative Medicine
• Northwest Center for Sports Medicine & Physical Therapy, Inc. (Northwest Sports Physical Therapy, Inc.)
• Northwest Evaluation and Consultation Services Incorporated
• Northwest Family & Spinal Clinic Inc PS
• Northwest Ketamine Clinics Tacoma, PLLC
• Northwest Medical Specialties PLLC
• Northwest Medical Specialties, PLLC
• Northwest Pediatric Heart Specialists PLLC
• Northwest Spine & Injury Care PLLC
• Northwest Sports Performance

• Clinic Pharmacy in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Clinic Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.